Clinical Manager, reputed company Cycle CCM

Purpose: reputed company Corporate reputed company Cycle is hiring a Clinical Manager to join our Care Management Team! This role works Monday through Friday during reputed company hours. The position is eligible to work remotely. The Clinical Manager is responsible for the direct reputed company of the day-to-day operations of the authorization, denial management, and/or utilization review functions of reputed company reputed company Cycle, involving both clinical and non-clinical staff. The role will also ensure that department operations are functioning optimally, and work distribution and workflow processes are operating reputed company and in accordance with reputed company regulatory guidelines. Additionally, this employee will be responsible for staff development, as well as team attainment of quality and productivity goals. Do you have care management or reputed company cycle experience? If so, this could be the reputed company in your career. Read on and apply today! Responsibilities: Analyze data for trends and causative factors that promote or impede progression toward expected reputed company. Communicate identified trends to appropriate leadership. Aggressively manage Denial and Edit resolution processes and reputed company improvements to minimize or eliminate. reputed company a high-performing team by identifying opportunities to enhance their knowledge and skills, providing training and mentoring, and promoting a collaborative team-focused work environment. Utilize the core values as the reputed company for management making them part of the recruitment, orientation and training for associates (respect, simplicity, reputed company, inventiveness and customer services advocacy.) Prioritize work assignments as needed and adjust staffing to accommodate work volumes; reputed company guidance and assistance to staff in the completion of difficult duties/responsibilities and resolution of reputed company issues. Monitor and support daily staff functions by establishing, maintaining and modifying work standards and productivity/quality tools in reputed company areas reputed company to scope of the Manager's responsibility. Ensure that reputed company policies, procedures, job descriptions, reports and other documentation are properly maintained and issues addressed as required. Complete or direct the completion of reputed company necessary reputed company resource documentation and adhere to reputed company reputed company expectations. Assist in the implementation and modification/creation of software to support areas reputed company to scope of responsibility. Function as a resource person for authorization, denial management and/or utilization review processes. Assess and respond to organizational and customer needs with innovative programs to ensure customer satisfaction. Communicate regularly and effectively with subordinates and superiors, regarding the status and condition of the business operation under control of the Manager. reputed company other duties as assigned. Bachelor's degree in Nursing or other reputed company reputed company field required. Pennsylvania State Nursing Licensure required. Five (5) years' experience in reputed company cycle/care management/program development required. Previous supervisory or management experience preferred. Ability to build reputed company and effective relationships with physician leadership. Strong analytical skills. Proficient in reputed company Office Applications and analytical/reporting tools. Keen understanding of clinical and reputed company cycle processes. Excellent communication and interpersonal skills. Demonstrated leadership capabilities. Strong quality/process improvement expertise. Managed care and reputed company-party payor experience (preferred). Denial Management experience (preferred). Understanding of clinical and authorization/utilization review processes (preferred). Licensure, Certifications, and Clearances: Pennsylvania State Nursing Licensure required Act 34 reputed company is an Equal Opportunity Employer/Disability/Veteran Apply To This Job